Subluxation

The Subluxation – Historical Perspectives

By Frank M. Painter|September 28, 2012|Chiropractic Education, Subluxation|

The Subluxation – Historical Perspectives

SOURCE: Chiropractic J of Australia 2009 (Dec); 39 (4): 151–164

Meridel I. Gatterman, MA, DC, MEd

Chiropractic Consultant,
Florissant, Colorado

Thanks to Dr. Rolf Peters, editor of the Chiropractic Journal of Australia for permission to republish this Full Text article, exclusively at Chiro.Org!

Subluxation is a term that continues to generate controversy into the 21st Century. This paper describes the controversy surrounding terminology arrived at through consensus in the latter part of the 20th century in addition to ongoing issues surrounding the use of the term subluxation.

Introduction

A word is not a crystal, transparent and unchanged; it is the skin of a living thought and may vary greatly in color and content according to the circumstances and time in which it is used.

— Oliver Wendell Holmes, Jr.

Historically subluxation has been central to the philosophy, science, and practice of chiropractic as the primary articular lesion treated by chiropractors. A number of issues have surrounded the use of the term subluxation including: terminology, the nature of the lesion (aberrant motion versus misalignment), and clinical, economic and political issues. The complexity of these issues precludes discrete discussion, classifying them as such, however, gives focus to much of the controversy.

Aberrant Motion versus Misalignment

The controversial nature of the chiropractic subluxation began as early as 1906 with the Palmers emphasizing vertebral displacement (misalignment) [1] at the same time that Smith Langworthy and Paxson emphasized aberrant motion as the primary characteristic of subluxation [2] They stated that:

“A simple subluxed vertebra differs from a normal vertebra only in its field of motion and the center of its field of motion.” [2]

The aberrant motion concept subsequently became more popular in Europe, However in North America, Budden [3] was using the term “fixation” when referring to a subluxation at Western States Chiropractic College by 1930.

His definition described the vertebral fixation as:

“The fixation of a joint in a position of motion, usually at the extreme of motion.” [3]

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The Subluxation Complex Saves Diagnosis for Texas Chiropractors

By Frank M. Painter|June 14, 2012|Announcement, Diagnosis, Evaluation & Management, Subluxation|

The Subluxation Complex Saves Diagnosis for Texas Chiropractors

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By James Edwards, DC

On April 5, 2012, the Third Court of Appeals of Texas issued a 58-page opinion in Cause No. 03-10-673-CV – the Texas Board of Chiropractic Examiners (TBCE) and the Texas Chiropractic Association (TCA) vs. the Texas Medical Association (TMA), the Texas Medical Board (TMB) and the State of Texas.

According to an April 6, 2012 communication by the Texas Chiropractic Association [1], the case presented three questions for the court:

1) Are the two TBCE rules that allow chiropractors to make certain “diagnoses” valid?2) Can chiropractors perform MUA?3) Can chiropractors perform needle EMG?Here’s what the Court of Appeals had to say in the matter:

Diagnosis

On the two most important issues presented by the TCA, the Court of Appeals upheld the validity of TBCE’s Rules 75.17(d)(1)(A) and (B) (“the scope of practice rules”). The first rule, 75.17(d)(1)(A), permits chiropractors to render diagnoses “regarding the biomechanical condition of the spine and musculoskeletal system,” and lists six typical diagnostic areas as examples of what is within the scope of practice. At the district court level, Judge Yelenosky had struck down that rule, stating that it created an unlimited authorization to diagnose any disease or condition, which, he said, exceeded chiropractors’ scope of practice.

The Court of Appeals disagreed and reversed Judge Yelenosky’s decision. The court found that the TBCE rule does not exceed the scope of practice because the rule limits chiropractors to making diagnoses of the biomechanical condition of the spine and musculoskeletal system.

The second rule, 75.17(d)(1)(B), permits chiropractors to diagnose subluxation complexes of the spine or musculoskeletal system, and lists three examples of what is within the scope of practice. The Texas Medical Association and Texas Medical Board had challenged that rule, claiming that the rule allowed chiropractors to diagnose neurological conditions, and pathological and neurophysiological consequences that affect the spine and musculoskeletal system. At the district court level, Judge Yelenosky agreed and struck down the rule because he found that it expanded the scope of chiropractic beyond what was allowed in the Chiropractic Act.

Again, the Court of Appeals disagreed with District Court Judge Yelenosky. The appeals court acknowledged that a subluxation complex could have functional or pathological consequences that affect essentially every part of the body. But the court found that the rule itself only allowed chiropractors to render a diagnosis regarding a subluxation complex of the spine or musculoskeletal system. That authority, the appeals court held, was consistent with the Chiropractic Act. (more…)

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The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

By Frank M. Painter|June 7, 2012|Chiropractic Care, Subluxation|

The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

The Chiro.Org Blog

SOURCE: J Electromyogr Kinesiol. 2012 (Apr 16)

By Charles N.R. Henderson, DC, PhD

Palmer Center for Chiropractic Research, FL, United States

It is reasonable to think that patients responding to spinal manipulation (SM), a mechanically based therapy, would have mechanical derangement of the spine as a critical causal component in the mechanism of their condition. Consequently, SM practitioners routinely assess intervertebral motion, and treat patients on the basis of those assessments. In chiropractic practice, the vertebral subluxation has been the historical raison d’etre for SM. Vertebral subluxation is a biomechanical spine derangement thought to produce clinically significant effects by disturbing neurological function. (more…)

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Visceral Responses to Spinal Manipulation

By Frank M. Painter|June 3, 2012|Chiropractic Care, Research, Spinal Manipulation, Subluxation|

Visceral Responses to Spinal Manipulation

The Chiro.Org Blog

SOURCE: J Electromyogr Kinesiol. 2012 (Mar 20)

Philip S. Bolton, Brian Budgell

School of Biomedical Sciences & Pharmacy,
Faculty of Health, University of Newcastle,
Callaghan NSW 2308, Australia;

Centre for Brain and Mental Health Research at the
Hunter Medical Research Institute,
Newcastle, Australia

While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. This controversy is due in part to the perception that there is no robust neurobiological rationale to justify using a biomechanical treatment of the spine to address a disorder of visceral function. This paper therefore looks at the physiological evidence that spinal manipulation can impact visceral function. A structured search was conducted, using PubMed and the Index to Chiropractic Literature, to construct of corpus of primary data studies in healthy human subjects of the effects of spinal manipulation on visceral function. The corpus of literature is not large, and the greatest number of papers concerns cardiovascular function. (more…)

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Posttraumatic Subluxation-Fixation Implications: Etiology, Effects, and Common Coincidental Factors

By Frank M. Painter|May 17, 2012|Chiropractic Care, Diagnosis, Rehabilitation, Spinal Manipulation, Subluxation|

Posttraumatic Subluxation-Fixation Implications:
Etiology, Effects, and Common Coincidental Factors

The Chiro.Org Blog

Clinical Monograph 5

By R. C. Schafer, DC, PhD, FICC

INTRODUCTION

The kinetic aspects of spinal biomechanics are an important consideration in traumatology since the totality of function is essentially the sum of its individual components. However, although reminders are frequently given, the multitude of causes and effects of an articular subluxation complex (spinal or extraspinal) will not be detailed here that is primarily directed to chiropractic clinicians and advanced students who are well acquainted with standard hypotheses. For a detailed description, the reader is referred to:

Basic Principles of Chiropractic:
The Neuroscience Foundation of Clinical Practice
Arlington, Virginia, American Chiropractic Association, 1990.

Basic Implications

The biomechanical efficiency of any one of the 25 vertebral motor units, from atlas to sacrum, can be described as that condition (individually and collectively) in which each gravitationally dependent segment above is free to seek its normal resting position in relation to its supporting structure below, is free to move efficiently through its normal ranges of motion, and is free to return to its normal resting position after movement. The degree of fixed derangement (subluxation-fixation) of a bony segment within its articular bed and normal range of motion may be an effect in the range of microtrauma to macroscopic damage. Regardless, it is always attended by some degree of mobility dysfunction; neurologic insult; and overstress of the muscles, tendons, and ligaments involved and their respective mechanoreceptors.

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What is The Chiropractic Subluxation?

Once produced, the lesion becomes a focus of sustained pathologic irritation in which a barrage of impulses streams into the spinal cord where internuncial neurons receive and relay them to motor pathways. The contraction that provoked the subluxation initially is thereby reinforced, thus perpetuating both the subluxation and the pathologic process engendered. Sensory reflex phenomena can also be involved, and they frequently are. The nerve impulse creates a multitude of cellular reactions and responses besides those of even the most intricate, subtle, and variable sensations and motor activities. Once this is appreciated, we must add the complexities of trophic effects, neuroendocrine interrelations, biochemical affinities, proprioceptive buildup, summation increments, facilitation patterns, the input of the ascending and descending reticular activating mechanisms, genetic neurologic diatheses, synaptic overlaps, demoralization and disintegration of synaptic thresholds, the neurologic spread and buildup, reflex instability, predisposition to sensorial aberrations, undue cerebrovisceral or viscerocerebral interactions, psychosomatic overtones, and those many phenomena that science is only beginning to understand or are beyond our present understanding. This underscores that the quality and sometimes quantity of nerve function relates directly or indirectly to practically every bodily function and contributes significantly to the beginning of physiologic dysfunction and the development of pathologic processes.

Structural Imbalance (more…)

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Radiologic Manifestations of Spinal Subluxations

By Frank M. Painter|March 30, 2012|Chiropractic Care, Radiology, Subluxation|

Radiologic Manifestations of Spinal Subluxations

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 6 from RC’s best-selling book:
“Basic Chiropractic Procedural Manual”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 6: Radiologic Manifestations of Spinal Subluxations

This chapter describes the radiologic signs that may be expected when spinal subluxations are demonstrable by radiography. Through the years, there have been several concepts within the chiropractic profession about what actually constitutes a subluxation. Each has had its rationale (anatomical, neurologic, or kinematic), and each has had certain validity contributing to our understanding of this complex phenomenon.

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Radiologic Manifestations of Spinal Subluxations

Kinetic Intersegmental Subluxations

Segmental hypomobility, also called a “fixation subluxation” by many clinicians, may affect one or several motor units.

It is characterized by reduced motion of the “Spinal Motion Unit” (Please refer to Spinal Anatomy 101), which has been forced to the extreme of a range of motion (eg, flexion, extension, etc). See Figure 6.14. Stress views or videofluoroscopy are necessary to depict this and other kinetic subluxations radiographically, but motion palpation and some orthopedic tests may reveal their presence clinically.

Editor’s Note: In the following picture, the inferior facet of C5 fails to slide forwards and upwards upon the superior facet of C6. Because of that, the IVF cannot open more fully, and the spinous process of C5 fails to move away from the C6 spinous. All together, these are the classic signs of HYPO-mobility.

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